Centre for Health Systems and Safety Research, Australian Institute of Health Innovation (AIHI), Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109, Australia.
School of Population Health, University of New South Wales (UNSW) Sydney, Level 2, Samuels Building, Kensington, NSW 2052, Australia.
Int J Qual Health Care. 2021 Oct 29;33(4). doi: 10.1093/intqhc/mzab145.
Medication safety remains a pertinent issue for health systems internationally, with patients from ethnic minority backgrounds recognized at increased risk of exposure to harm resulting from unsafe medication practices. While language and communication barriers remain a central issue for medication safety for patients from ethnic minority backgrounds, increasing evidence suggests that unconscious bias can alter practitioner behaviours, attitudes and decision-making leading to unsafe medication practices for this population. Systemwide, service and individual level approaches such as cultural competency training and self-reflections are used to address this issue, however, the effectiveness of these strategies is not known. While engagement is proposed to improve patient safety, the strategies currently used to address unconscious bias seem tokenistic. We propose that including consumers from ethnic minority backgrounds in design and delivery of the education programs for health professionals, allocating extra time to understand their needs and preferences in care, and co-designing engagement strategies to improve medication related harm with diverse ethnic minority groups are key to mitigating medication related harm arising as a result of unconscious bias.
药物安全仍然是国际卫生系统的一个重要问题,少数族裔背景的患者面临更高的风险,可能因不安全的用药行为而受到伤害。尽管语言和沟通障碍仍然是少数族裔背景患者药物安全的核心问题,但越来越多的证据表明,无意识偏见会改变从业者的行为、态度和决策,从而导致这一人群的用药不安全。在系统层面、服务层面和个人层面上,例如文化能力培训和自我反思等方法被用来解决这个问题,但是这些策略的效果还不清楚。虽然参与被认为可以提高患者的安全性,但是目前用来解决无意识偏见的策略似乎只是象征性的。我们提出,让少数族裔背景的消费者参与卫生专业人员教育项目的设计和实施,额外分配时间来了解他们在护理方面的需求和偏好,共同设计参与策略,以改善与不同少数族裔群体的药物相关伤害,这些都是减轻因无意识偏见而导致的药物相关伤害的关键。